Evaluation of the Effect of Body Mass Index and Body Fat Percentage on the Maximal Oxygen Consumption: A Cross-Sectional Study

Page created by Anita Walsh
 
CONTINUE READING
Corrected Proof

Jundishapur J Health Sci. 2019 April; 11(2):e87283.                                                                                        doi: 10.5812/jjhs.87283.

Published online 2019 February 4.                                                                                                                 Research Article

Evaluation of the Effect of Body Mass Index and Body Fat Percentage
on the Maximal Oxygen Consumption: A Cross-Sectional Study
Davood Afshari 1 , Mohammad Rami 2 , Gholam Abbas Shirali 1 and Narges Azadi 1, *
1
    Department of Occupational Health Engineering, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2
    Department of Sport Physiology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
*
 Corresponding author: Department of Occupational Health Engineering, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Tel:
+98-09168875009, Fax:+98-6113738282 , Email: n.azadi1991@yahoo.com

Received 2018 December 10; Revised 2019 January 28; Accepted 2019 January 30.

     Abstract

     Background: In order to assess the cardiorespiratory condition of people and as a result to create a physiological symmetry be-
     tween work and worker, physical work capacity is of high importance and can play a special role in choosing qualified workforce.
     Objectives: The current study aims to evaluate work capacity and examine the effect of body mass index (BMI) and body fat percent-
     age (BFP) on aerobic capacity.
     Methods: In this cross-sectional study, 50 male university students voluntarily participated. Work capacity was measured with the
     use of a treadmill and the Bruce protocol. BMI and BFP, as the variables of the research, were measured using the device while the
     subjects were undergoing the test. The relationship between the variables was investigated using the Pearson correlation test.
     Results: The mean and standard deviation of age for the people under the study was obtained as 21.36 ± 2.08 years. The mean
     and standard deviation of the aerobic capacity was estimated at 44.01 ± 4.75 (mL/kg/min). The results showed that there was a
     significant inverse relationship between BMI, BFP, and Maximal oxygen consumption (VO2 max). The level of significant was set as
     0.05 (P ≤ 0.05).
     Conclusions: The findings indicated that BMI and BFP, as the variables, were effective factors in the people’s aerobic capacity. These
     indices can be used as a criterion for determining the aerobic capacity of people.

     Keywords: Physical Work Capacity, Body Mass Index, Body Fat Percentage, Treadmill Test

1. Background                                                                             cardiorespiratory system (6, 7). The main unit for maxi-
                                                                                          mal aerobic capacity measurement is expressed in l/min
     One of the most important applications of ergonomic                                  or mL/min. However, as the absolute value of this variable
science is adapt the work type with human capabilities                                    is strongly affected by body weight, it is often expressed
and limitations (1). Hence, to measure physical activity,                                 with unit of mL/kg/min (8). Various factors affect the maxi-
capacity is one of the important topics of ergonomic sci-                                 mal aerobic capacity, including environmental, psycholog-
ence, which has been emphasized by the International La-                                  ical, physical, and physiological characteristics of individ-
bor Organization (2). One of the effective measures in                                    uals (9). With increasing the aerobic power, that is, oxy-
this regard is to measure the physical work capacity (3).                                 gen uptake capacity, the physical power will be higher. It
The physical work capacity (PWC) is the maximum level of                                  means that an individual can perform heavy activities bet-
energy, which an individual can use in an 8-hour period                                   ter and more easily. Thus, aerobic power is an appropriate
in kcal/min without experiencing any physiological stress                                 criterion to express the physical ability of individuals to
and physical fatigue (4). Nowadays, scientists state that the                             perform work or an individual fitness with the work (10).
maximal oxygen consumption (VO2 max) should be used                                       Physical fitness includes five elements of aerobic capacity,
to determine the physical work capacity (2). The maximal                                  muscle strength, muscle endurance, flexibility, and body
aerobic capacity reflects the maximal oxygen transfer rate                                composition (11). Research has indicated that the physi-
of the muscles, which is acceptable in many cases to mea-                                 cal composition of individuals as another physical factor
sure the fitness between the individual and the considered                                is closely associated with aerobic fitness. The studies con-
work (5). Maximal oxygen consumption is considered as                                     ducted in this regard indicate that the maximal aerobic
a first-class standard to measure the practical limit of the                              capacity is associated with body composition factors such

Copyright © 2019, Jundishapur Journal of Health Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial
4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the
original work is properly cited.
Corrected Proof

                                                             Afshari D et al.

as body fat percentage, body mass index, and body mus-                  exercise were excluded from the study. The test to de-
cle mass (12, 13). Researchers have also presented valid es-            termine the physical work capacity was performed using
timates of aerobic fitness using the variables of age, gen-             the Bruce protocol on h/p/cosmos company treadmill (Sat-
der, body fat percentage, and body mass index (BMI) (14,                urn model, Germany), gas analyzer (ergospirometry) (Gun-
15). Results of previous studies suggest that low physical              shorn model, Germany). Bruce Treadmill test includes
activity results in a low level of physical fitness and, as a re-       seven 3-minute steps (21). The form and speed of the tread-
sult, high body fat percentage (16). The maximal aerobic                mill are automatically changed owing to an increase in
capacity will be measured based on the precision required               slope at each step (20). In the first step, an individual starts
and the existing level of risk by using various methods, in-            walking at a speed of 2.7 km/h and a slope of 10%. In the sec-
cluding direct and indirect methods (17). In the indirect               ond step, the speed increases to 4 km/h and the slope in-
method, laboratory tests based on heartbeat response are                creases to 12%. The speed and slope, respectively, increased
used (18). Direct measurement of VO2 max requires special-              to 5.5 km/h and 14%, 6.8 km/h and 16%, 8 km/h and 18%, 8.9
ized equipment and considerable physical effort and mo-                 km/h and 20%, and 9 km/h and 22% in the following steps
tivation. Moreover, when high precision is required, direct             (20, 21). The body fat percentage and body mass index were
tests are used to determine the maximal oxygen consump-                 measured, while the participants had on light clothing,
tion (17). Cycle ergonomic, conveyor belt, and stair test are           by using a machine method. The height of the subjects
the tools used to measure the maximal aerobic capacity of               was measured, without any shoes on, by using a tape me-
individuals (19). In addition, Treadmill Bruce test is used             ter with a precision of 0.1 cm. Moreover, the components
as a standard method to measure the aerobic capacity and                of the body composition of the subjects including weight,
cardiovascular fitness of athletes or healthy non-athlete in-           body mass index, and body fat percentage were measured
dividuals (20).                                                         by using the direct reading method and Body Composition
                                                                        Device (Olympia3.3 model, Korea) during performing the
                                                                        Treadmill Bruce. The data were analyzed using the SPSS 21
2. Objectives                                                           software after performing the necessary measurements. In
                                                                        this study the variables were continuous and the distribu-
    Very limited studies have been conducted so far in Iran
                                                                        tion of data was normal (one-sample Kolmogorov-Smirnov
to evaluate the effect and the relationship between body fat
                                                                        test), hence the Pearson correlation coefficient was used to
percentage and body mass index on work capacity of indi-
                                                                        test the hypothesis to determine the relation between BMI,
viduals. Most of the studies conducted in this regard used
                                                                        BFP, and VO2 max of the research participants.
indirect methods, which have lower precision in the esti-
mation of physical activity capacity. Hence, the present re-
search was carried out to estimate the capacity of physical             4. Results
activity and evaluate the correlation between body fat per-
                                                                             A total of 50 Ahvaz University of Medical Sciences stu-
centage and body mass index using direct reading meth-
                                                                        dents, with the age range of 20 - 30 years, participated vol-
ods. Given the high accuracy and precision of the mea-
                                                                        untarily in this research. The mean age of the participants
sured parameters, the present research can be used as ap-
                                                                        was 21.36 ± 2.08 years. The mean and standard deviation
propriate in the assessment perform activity capacity.
                                                                        of the height of the subjects were also 176.16 ± 6.02 cm.
                                                                        The mean of maximal aerobic capacity of the subjects in
3. Methods                                                              this research was estimated 44.01 ± 4.75 (mL/kg/min) us-
                                                                        ing a Bruce Treadmill test. Table 1 illustrates the mean and
    This is a cross-sectional study conducted on 50 male                standard deviation of the components of the body compo-
volunteer students of Ahvaz University of Medical Sciences              sition studied.
with an age range of 20 - 30 years to examine the factors
affecting the work capacity of the subjects. Necessary ex-              Table 1. Descriptive Data for Body Composition Parameters

planations were provided on the method of implement-                      Body Composition Parameters                               Mean ± SD
ing the work and the consent of participants was taken                    Weight, kg                                                74.78 ± 15.01
to complete the form of demographic information ques-
                                                                          Body mass index, kg/m2                                    24.03 ± 4.31
tionnaire. After completing the questionnaire the subjects
                                                                          Body Fat, %                                               20.77 ± 7.6
were prepared to perform the work capacity test by con-
sidering the inclusion criteria, including lack of history of
cardiovascular, respiratory, musculoskeletal disease, and                  Table 2 illustrates the correlation between body fat per-
lack of history of drug use. Participants with history of               centage, body mass index, and physical work capacity of

2                                                                                            Jundishapur J Health Sci. 2019; 11(2):e87283.
Corrected Proof

                                                                           Afshari D et al.

Table 2. Correlation Between BFP and BMI with VO2 max
                                                                                                                              BFP
           Variable                               P Value        R Value
                                                                                                       60
           Body fat, %                             0.00           - 0.87
                                                                                                       50

                                                                                      VO2, ml/kg/min
           Body mass index, kg/m2                  0.00          - 0.959
                                                                                                       40
                                                                                                       30
                                                                                                                                R² = 0.756
                                         BMI                                                           20
                 60                                                                                    10
                 50                                                                                    0
                                                                                                            0   10            20              30               40
VO2, mL/kg/min

                 40
                                                                                                                             BFP
                 30

                 20                                                                   Figure 2. Correlation between maximum oxygen uptake (mL/kg/min) and body fat
                                         R² = 0.919                                   percent (%)
                 10

                 0
                      0        10         20                30              40
                                                                                      ship between age and work capacity, we can refer to the
                                         BMI
                                                                                      limited age range and the younger age of all participants
Figure 1. Correlation between maximum oxygen uptake (mL/kg/min) and body              of the research.
mass index                                                                                The mean and standard deviation of VO2 max in the
                                                                                      subjects was estimated as 44.01 ± 4.75 in terms of
                                                                                      mL/kg/min. This value was close to the results of the
the subjects. The results suggest a significant and reverse
                                                                                      research conducted by Mondal and Mishra (17) in males
correlation between the variables of body composition
                                                                                      (43.25 ± 7.25 mL/kg/min) and Sterkowicz et al. (41.9 ± 4.62
and VO2 max the physical work capacity of the subjects (P
                                                                                      mL/kg/min) (25). In addition, the results of this research
≤ 0.05).                                                                              were high than those reported in the research conducted
    In addition, the results of simple linear regression
                                                                                      by Hosseinabadi et al. (36.9 ± 3.72 mL/kg/min), Danesh-
analysis suggest a significant and linear relationship be-
                                                                                      mandi et al. (35.95 ± 7.39 mL/kg/min) and Rafieepour et
tween BMI and VO2 max (R2 = 0.919, P ≤ 0.001). This corre-
                                                                                      al. (32.60 ± 10.39 mL/kg/min) (10, 24, 26). The mean age
lation suggests that the physical work capacity of individu-
                                                                                      of the participants was 40 years in the research conducted
als decreases with increasing the body mass index (Figure
                                                                                      by Hosseinabadi et al. (10) and 32.01 years in the research
1).
                                                                                      conducted by Daneshmandi et al. (24). As the participants
    In addition, with regard to the relationship between                              in the research are at a young age, with the mean age be-
two variables of body fat percentage and VO2 max, simple                              ing 21.36 years, the inconsistency can be attributed to the
linear regression analysis results show a significant and                             difference in work capacity in different age groups and the
negative linear relationship between these two variables (P                           limited age range of the subjects (young students). In ad-
≤ 0.001, R2 = 0.756). This relationship indicates reduction                           dition, in the research conducted by Rafieepour, 58.1% of
in the work capacity of individuals as a result of an increase                        the participants were female (26). As this research was con-
in BFP (Figure 2).                                                                    ducted on males, and gender is a factor affecting the phys-
                                                                                      ical work capacity, the difference in results might be due
5. Discussion                                                                         to the effect of gender on the individuals’ work capacity. In
                                                                                      this research, the mean BMI and BFP was determined (24.03
    The objective of this research was to evaluate the rela-                          ± 4.31) kg/m2 and (20.77 ± 7.6)%, respectively. Based on
tionship between body fat percentage, body mass index,                                the World Health Organization (WHO), the BMI of the sub-
and physical work capacity. In this research, the mean age                            jects was within the normal range of (18.5 - 25) kg/m2 (19).
of participants was 21.36 ± 2.08 years. According to the re-                          In this regard, the relationship between body mass index
sults of this research, there was no significant relationship                         and maximal work capacity in this study showed a signif-
between mean VO2 max and age. This result was consistent                              icant relationship between these variables. These results
with that of studies conducted by Mombeini et al. (9) and                             showed that the value of VO2 max, in terms of mL/kg/min,
Habibi et al. (22). However, it was inconsistent with result                          decreased with an increase in BMI. It is in line with result of
of the study conducted by Chatterjee et al. (23) and Danesh-                          previous studies (27-29). The results of studies conducted
mandi et al. (24). In justifying lack of a significant relation-                      by Mondal and Mishra (17), Sterkowicz et al. (25), Hsieh et al.

Jundishapur J Health Sci. 2019; 11(2):e87283.                                                                                                                   3
Corrected Proof

                                                           Afshari D et al.

(30), and Laxmi et al. (31) were consistent with the results          capability of people finding various jobs. As the measure-
of this research. With regard to the reverse relationship be-         ment of these variables using indirect methods has a lower
tween body mass index and VO2 max, several studies have               precision, it is recommended that direct reading methods
referred to the effect of weight and body composition on              be used to estimate the work capacity and the correlation
VO2 max, which might be due to the physiological effects              between these variables and the capacity of performing
of weight gain. Weight gain and BMI increases the body’s              the work.
need for blood supply to the tissues, and owing to limited
heart’s capacity, blood is not supplied well to tissues, there-
                                                                      Acknowledgments
fore, the oxygen available to the tissues is reduced (32). In
this research, the mean and standard deviation of the BFP                 The authors of this research appreciate the Sports Phys-
in the studied students were estimated to be 20.77 ± 7.6%,            iology Department of Shahid Chamran University of Ahvaz
which was within the normal range (16% - 24%) (17). Accord-           as well as its participants for their cooperation in this re-
ing to the results of this research, a significant and nega-          search.
tive relationship was found between work capacity of in-
dividuals and body fat percentage (% PBF), which is consis-
tent with the results of research conducted by Amani et al.           Footnotes
(20), Minasian et al. (33), and Ostojic et al. (34). In addi-
                                                                      Authors’ Contribution: Davood Afshari: Developing
tion, in a research conducted by Shete et al. (8) and Pribis et
                                                                      the study concept, design, and methods. Narges Azadi
al. (35), there was a negative relationship between VO2 max
                                                                      and Davood Afshari: Writing the primary draft of the
and BFP. Increased fat around the heart, which occurs usu-
                                                                      manuscript. Davood Afshari, Mohammad Rami, Narges
ally due to obesity, can reduce the heart pumping. Thus, it
                                                                      Azadi, and Gholam Abbas Shirali: Contributing to the
might finally reduce the heart capacity and the ability of
                                                                      development of the study protocol, data analysis, and
performing the daily tasks (20, 32).
                                                                      manuscript drafting. All authors contributed to the revi-
     The results of this research showed a significant and
                                                                      sion of the manuscript and read and approved the final ver-
negative correlation between body mass index and body
                                                                      sion.
fat percentage as well as capacity for performing the phys-
                                                                      Conflict of Interests: The authors declare that they have
ical works. These results showed that BMI and BFP vari-
                                                                      no conflict of interests.
ables are among the factors affecting the capacity of in-
dividuals to perform their physical works. This study is              Ethical Considerations: The authors received an ethical
one of the first studies conducted to estimate the associ-            approval code (ir.ajums.rec.1397.279) from Ahvaz Jundisha-
ation between body fat percentage, body mass index, and               pur University of Medical Sciences. Necessary explanations
VO2 max using direct reading method. The results of this              were provided on the method of implementing the work
research showed that the limitations of previous studies,             and the consent of participants was taken to complete the
which used the indirect methods with lower precision to               form of demographic information questionnaire.
estimate the capacity performing physical works, can be               Funding/Support: There was no funding or support for
resolved by estimating these variables using direct read-             this study. It was done as a Master of Science project.
ing methods. Some of the limitations of this research in-
cluded the cross-sectional nature of the research and the
                                                                      References
lack of observing the effect of different factors over time,
the limited population, and the lack of evaluating the ef-             1. Heydari P, Jafarvand M, Alizadeh SS, Varmazyar S, Hakimi C. [Pre-
fect of gender on work capacity. Hence, it is recommended                 dicting maximum oxygen consumption based on anthropometric
that similar studies be conducted with larger sample size                 dimensions in medical emergency students]. Iran Occup Health J.
                                                                          2018;14(6). Persian.
and on workers.                                                        2. Habibi E, Khalili GH, Karimi A, Mobasheri DM, Babaei PA, Moghiseh M,
                                                                          et al. [Factors affecting the maximum aerobic capacity of mine work-
                                                                          ers in Isfahan, Iran]. Health Sys Res. 2016;13(2). Persian.
5.1. Conclusions                                                       3. Heydari P, Mohammadzadeh E, Varmazyar S, Beigzadeh F. [Correla-
                                                                          tion of treadmill and step tests in estimation of maximum in esti-
    One of the important factors in job ergonomics is de-                 mating the maximum aerobic capacity (VO2max)]. Iran Occup Health.
termining the capacity of performing the physical work.                   2016;13(2):1–9. Persian.
The results of this research suggest the effect of body fat            4. Heydari P, Varmazyar S, Nikpey A, Variani AS, Jafarvand M. Step test: A
                                                                          method for evaluating maximum oxygen consumption to determine
percentage and body mass index on the capacity of per-
                                                                          the ability kind of work among students of medical emergencies.
forming the works; which might be effective in selecting                  Electron Physician. 2017;9(3):4020–6. doi: 10.19082/4020. [PubMed:
the appropriate people based on type of activity and the                  28461880]. [PubMed Central: PMC5407238].

4                                                                                        Jundishapur J Health Sci. 2019; 11(2):e87283.
Corrected Proof

                                                                        Afshari D et al.

  5. Siconolfi SF, Garber CE, Lasater TM, Carleton RA. A simple, valid                     MY, et al. Relationship between body fat percent and maximal oxygen
     step test for estimating maximal oxygen uptake in epidemiologic                       uptake among young adults. J Am Sci. 2010;6(4):1–4.
     studies. Am J Epidemiol. 1985;121(3):382–90. doi: 10.1093/oxfordjour-         21.     Stevens J, Cai J, Evenson KR, Thomas R. Fitness and fatness as predic-
     nals.aje.a114010. [PubMed: 4014128].                                                  tors of mortality from all causes and from cardiovascular disease in
  6. Huggett DL, Connelly DM, Overend TJ. Maximal aerobic capacity test-                   men and women in the lipid research clinics study. Am J Epidemiol.
     ing of older adults: A critical review. J Gerontol A Biol Sci Med Sci.                2002;156(9):832–41. doi: 10.1093/aje/kwf114. [PubMed: 12397001].
     2005;60(1):57–66. doi: 10.1093/gerona/60.1.57. [PubMed: 15741284].            22.     Habibi E, Dehghan H, Zeinodini M, Yousefi H, Hasanzadeh A. A study
  7. Astorino TA, Willey J, Kinnahan J, Larsson SM, Welch H, Dalleck                       on work ability index and physical work capacity on the base of fax
     LC. Elucidating determinants of the plateau in oxygen consump-                        equation VO(2)max in male nursing hospital staff in Isfahan, Iran.
     tion at VO2max. Br J Sports Med. 2005;39(9):655–60. discussion 660.                   Int J Prev Med. 2012;3(11):776–82. [PubMed: 23189229]. [PubMed Central:
     doi: 10.1136/bjsm.2004.016550. [PubMed: 16118305]. [PubMed Central:                   PMC3506089].
     PMC1725313].                                                                  23.     Chatterjee S, Mitra SK, Samanta A. Aerobic capacity of the brick-field
  8. Shete AN, Bute SS, Deshmukh PR. A study of VO2max and body fat                        workers in eastern India. Ind Health. 1994;32(2):79–84. doi: 10.2486/in-
     percentage in female athletes. J Clin Diagn Res. 2014;8(12):BC01–3. doi:              dhealth.32.79. [PubMed: 7806448].
     10.7860/JCDR/2014/10896.5329. [PubMed: 25653935]. [PubMed Cen-                24.     Daneshmandi H, Fard AR, Choobineh A. Estimation of aerobic capac-
     tral: PMC4316241].                                                                    ity and determination of its associated factors among male workers
  9. Mombeini M, Habibi E, Yadegarfar G, Ordudari Z, Noorouzi H, Koo-                      of industrial sector of Iran. Int J Occup Saf Ergon. 2013;19(4):667–73. doi:
     livand Z. Association of maximum aerobic capacity with general                        10.1080/10803548.2013.11077014. [PubMed: 24321645].
     health, occupational fatigue, and job satisfaction among female               25.     Sterkowicz S, Lech G, Pałka T, Tyka A, Sterkowicz-Przybycień KL,
     employees in Isfahan hospitals, Iran. J Occupa Hygiene Eng Volume.                    Szyguła Z, et al. Body build and body composition vs. Physical capacity
     2018;5(1):61–9. doi: 10.21859/johe-5.1.61.                                            in young judo contestants compared to untrained subjects. Biol Sport.
10. Hosseinabadi S, Hamidi BP, Ebrahimi H, Barkhordari A, Raie BT. Esti-                   2011;28(4).
     mation of aerobic capacity (VO2max) and physical work capacity in             26.     Rafieepour A, Farasati F, Kalantari S, Motamedzadeh M, Rafieepour
     laborers. Knowl Health. 2013;8(3):131–7.                                              E. Estimation of maximum aerobic capacity and the effect. Qom Univ
 11. Nabi T, Rafiq N, Qayoom O. Assessment of cardiovascular fitness                       Med Sci J. 2014;8(3).
     [VO2max] among medical students by Queens College step test. Int J            27.     Ozcelik O, Aslan M, Ayar A, Kelestimur H. Effects of body mass index on
     Biomed Adv Res. 2015;6(5):418–21. doi: 10.7439/ijbar.                                 maximal work production capacity and aerobic fitness during incre-
12. Hill AM, Buckley JD, Murphy KJ, Howe PR. Combining fish-oil supple-                    mental exercise. Physiol Res. 2004;53(2):165–70. [PubMed: 15046552].
     ments with regular aerobic exercise improves body composition and             28.     Welch BE, Riendeau RP, Crisp CE, Isenstein RS. Relationship of max-
     cardiovascular disease risk factors. Am J Clin Nutr. 2007;85(5):1267–74.              imal oxygen consumption to various components of body compo-
     doi: 10.1093/ajcn/85.5.1267. [PubMed: 17490962].                                      sition. J Appl Physiol. 1958;12(3):395–8. doi: 10.1152/jappl.1958.12.3.395.
13. Tomassoni TL, Blanchard MS, Goldfarb AH. Effects of a rebound ex-                      [PubMed: 13525300].
     ercise training program on aerobic capacity and body composition.             29.     Grassi GP, Turci M, Sforza C. Aerobic fitness and somatic growth in
     Phys Sportsmed. 1985;13(11):110–5. doi: 10.1080/00913847.1985.11708928.               adolescents: A cross sectional investigation in a high school context.
     [PubMed: 27410016].                                                                   J Sports Med Phys Fitness. 2006;46(3):412–8. [PubMed: 16998445].
14. Cao ZB, Miyatake N, Higuchi M, Ishikawa-Takata K, Miyachi M, Tabata            30.      Hsieh PL, Chen ML, Huang CM, Chen WC, Li CH, Chang LC. Physi-
     I. Prediction of VO2max with daily step counts for Japanese adult                     cal activity, body mass index, and cardiorespiratory fitness among
     women. Eur J Appl Physiol. 2009;105(2):289–96. doi: 10.1007/s00421-                   school children in Taiwan: A cross-sectional study. Int J Environ Res Pub-
     008-0902-8. [PubMed: 18985375].                                                       lic Health. 2014;11(7):7275–85. doi: 10.3390/ijerph110707275. [PubMed:
15. Sanada K, Midorikawa T, Yasuda T, Kearns CF, Abe T. Development                        25032742]. [PubMed Central: PMC4113875].
     of nonexercise prediction models of maximal oxygen uptake in                  31.     Laxmi CC, Udaya IB, Vinutha Shankar S. Effect of body mass index on
     healthy Japanese young men. Eur J Appl Physiol. 2007;99(2):143–8. doi:                cardiorespiratory fitness in young healthy males. Int J Sci Res Publ.
     10.1007/s00421-006-0325-3. [PubMed: 17115179].                                        2014;4(2):25.
16. Matłosz P, Michałowska J, Sarnik G, Herbert J, Przednowek K, Grzywacz          32.     Farhadi S, Hesam G, Moradpour Z, Abazari M, Babayi MY. [Estimating
     R, et al. Analysis of the correlation between body composition, con-                  the maximum aerobic capacity of fire fighters using the step test, a
     struction and aerobic capacity in teenage team sport training. Eur J                  case study with height adjustable steps]. J Ergonomics. 2016;4(2):60–6.
     Clin Exp Med T.16, z. 2. 2018. doi: 10.15584/ejcem.2018.2.5.                          Persian. doi: 10.21859/joe-0402438.
 17. Mondal H, Mishra SP. Effect of bmi, body fat percentage and fat free          33.     Minasian V, Marandi SM, Kelishadi R, Abolhassani H. Correlation be-
     mass on maximal oxygen consumption in healthy young adults. J Clin                    tween aerobic fitness and body composition in middle school stu-
     Diagn Res. 2017;11(6):CC17–20. doi: 10.7860/JCDR/2017/25465.10039.                    dents. Int J Prev Med. 2014;5(Suppl 2):S102–7. [PubMed: 26157558].
     [PubMed: 28764152]. [PubMed Central: PMC5535345].                                     [PubMed Central: PMC4476005].
18. Rao AV, Phadke AV, Patil PB, Joshi AR. Comparison of non-exercise              34.     Ostojic SM, Stojanovic MD, Stojanovic V, Maric J, Njaradi N. Correla-
     test and step test in estimation of aerobic capacity (VO2max) in                      tion between fitness and fatness in 6-14-year old Serbian school chil-
     young adults. National J Phy Pharm Pharmacol. 2014;4(3):218. doi:                     dren. J Health Popul Nutr. 2011;29(1):53–60. doi: 10.3329/jhpn.v29i1.7566.
     10.5455/njppp.2014.4.150420141.                                                       [PubMed: 21528790]. [PubMed Central: PMC3075053].
19. Afshari D, Angali KA, Ahangar AS, Pour SM, Amirmoezi S. [Effects of an-        35.     Pribis P, Burtnack CA, McKenzie SO, Thayer J. Trends in body fat, body
     thropometric and demographic factors on physical work capacity of                     mass index and physical fitness among male and female college stu-
     students of Ahvaz University of Medical Sciences]. J Occup Hygiene Eng                dents. Nutrients. 2010;2(10):1075–85. doi: 10.3390/nu2101075. [PubMed:
     Volume. 2018;4(4):12–9. Persian. doi: 10.21859/johe.4.4.12.                           22253998]. [PubMed Central: PMC3257619].
20. Amani AR, Somchit MN, Konting MMB, Kok LY, Darestani SA, Ismail

Jundishapur J Health Sci. 2019; 11(2):e87283.                                                                                                                        5
You can also read